Parathyroid cancer, a very rare cancer, is a disease in which malignant cells are found in the tissues of the parathyroid gland. The parathyroid gland is at the base of the neck, near the thyroid gland. The parathyroid gland makes a hormone called parathyroid hormone (PTH), or parathormone, which helps the body store and use calcium.

Problems with the parathyroid gland are common and are usually not caused by cancer. If parathyroid cancer is found, the parathyroid gland may be making too much PTH. This causes too much calcium to be found in the blood. The extra PTH also takes calcium from the bones, which causes pain in the bones, kidney problems, and other types of problems. There are other conditions that can cause the parathyroid gland to make too much PTH. It is important for a doctor to determine what is causing the extra PTH. Hyperparathyroidism is a condition which can cause the body to make extra PTH. If hyperparathyroidism runs in the family, there is a greater chance of getting this type of cancer.

A doctor should be seen if there are the following symptoms: bone pain, a lump in the neck, pain in the upper part of the back, weak muscles, difficulty speaking, or vomiting.

If there are symptoms, the doctor will conduct a physical examination and feel for lumps in the throat. The doctor may also order blood tests and other tests to check for cancer or other types of tumours that may not be cancer (benign tumours).

The chance of recovery (prognosis) depends on whether the cancer is just in the parathyroid gland or has spread to other parts of the body (stage) and the patient’s general health.

How parathyroid cancer is treated

There are treatments for all patients with parathyroid cancer. Two kinds of treatment are used:

1. Surgery (taking out the cancer).
2. Radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells).

Surgery is the most common treatment of parathyroid cancer. A doctor may remove the parathyroid gland (parathyroidectomy) and the half of the thyroid on the same side as the cancer (ipsilateral thyroidectomy).

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumours. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).

Chemotherapy (using drugs to kill cancer cells) is being studied in clinical trials. Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the parathyroid gland.

Localized Parathyroid Cancer

Treatment may be one of the following:

1. Surgery to remove the parathyroid gland (parathyroidectomy) and the half of the thyroid on the same side as the cancer (ipsilateral thyroidectomy).
2. A clinical trial of surgery followed by radiation therapy.
3. A clinical trial of radiation therapy.

Metastatic Parathyroid Cancer

Treatment may be one of the following:

1. Surgery to remove the parathyroid gland (parathyroidectomy) and other tissues around the thyroid if they contain cancer.
2. Surgery to remove as much of the parathyroid gland as possible in order to reduce production of PTH.
3. Medical treatment to reduce the amount of calcium in the blood.
4. A clinical trial of surgery followed by radiation therapy.
5. A clinical trial of radiation therapy.
6. A clinical trial of chemotherapy.

Recurrent Parathyroid Cancer

Recurrent disease can occur as late as 34 years after the first tumour.

Treatment may be one of the following:

1. Surgery to remove the parathyroid gland (parathyroidectomy) and other tissues around the thyroid if they contain cancer.
2. Surgery to remove as much of the parathyroid gland as possible in order to reduce production of PTH.
3. Medical treatment to reduce the amount of calcium in the blood.
4. A clinical trial of surgery followed by radiation therapy.
5. A clinical trial of radiation therapy.
6. A clinical trial of chemotherapy.

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